腎癌患者における術前・術後の血清蛋白の変動

Abstract

1)腎癌の有転移, および無転移症例, 各15例, 計30例につき, 術前および術後の血清蛋白の変動を, 45種類の蛋白分画について, SRD法により測定した.2)術前より, Hx, C4, C3, Znα2, ClsIの高値を示す症例には, 術後, 高率に遠隔転移が認められた.3)有転移症例では, 術後もα1AT, α1AG, α1X, α2HS, Hp, Cp, C9, C5, β2III, C3PAの高値が認められた.4)有転移症例では, 術後もPre, Albの減少状態が持続した.5)有転移症例で, Fibronectinの低下が認められたことにより, 癌組織内でのfibrin沈着やfibrinogen代謝の亢進が示唆された

Using a micro-single radial immunodiffusion method, quantitative studies have been made on the serum proteins of 30 renal cancer patients; 15 patients without metastasis and 15 patients with metastasis, and expressed by percentage of those obtained on 98 normal volunteers regarded as 100%. Of 45 proteins studied, 4 (Pre, Alb, alpha 2HS and Tf) significantly decreased and 10 (alpha 1AT, alpha 1AG, alpha 1X, Hp, Cp, C9, C5, beta 2III, C4 and C3PA) significantly increased before nephrectomy in both patient groups. In postoperative follow-up studies of the non-metastasis patient group, Pre, Alb and alpha 2HS increased, while alpha 1AT, alpha 1AG, Hp, C9, C5, beta 2III, C4 and C3PA decreased, and normal levels were attained within 6 months after nephrectomy. In the metastasis patient group, no significant changes of these serum proteins were observed. Serum proteins showing significant difference between the 2 patient groups were more prominent 6 months after nephrectomy, namely, the majority of the dysproteinemia caused by the presence of renal cancer did not disappear even 1 month after extirpation of the tumor. alpha 1AT was normalized 1 month after nephrectomy at a highly significant difference, P less than 0.001, and considered one of the promising proteins in terms of clinical course evaluation. As a new finding, renal cancer group with metastasis showed a decrease of FN postoperatively suggesting increase of a fibrin deposition and fibrinogen metabolism in cancer tissue.